Center for Research, Prevention and Treatment of Atherosclerosis, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Internal Medicine Ward, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
PLoS One. 2018 Mar 28;13(3):e0195061. doi: 10.1371/journal.pone.0195061. eCollection 2018.
Previous studies have established a correlation between coronary artery calcification (CAC) measured by ECG-gated chest computed tomography (CT) and cardiovascular disease. Recent reports which included asymptomatic patients suggest that CAC measured on non-ECG gated CT is similarly associated with cardiovascular risk. This study investigates the correlation between the Framingham Risk Score (FRS) and an incidental finding of CAC on a non-gated chest CT performed for non-cardiac indications in young and seemingly healthy adults.
A cross-sectional study that included 162 CT scans performed in young patients aged 18-50 years old for non-cardiac indications in our institution was conducted. CAC score (CACS) was calculated using the Agatston method. FRS was calculated and compared to the CACS using three different approaches. The correlations between the CACS and several specific factors (i.e. age, body mass index, smoking, statins, etc.), were also evaluated.
Mean age of patients was 36.43 year old and 105 (64.8%) were male. We found a significant positive correlation between the CACS and the FRS in all three approaches (p<0.05). Increased age, smoking and statin use were the only individual factors clearly associated with an increase in CACS (p = 0.002, p = 0.045 and p = 0.009, respectively).
This is the first report indicating that incidental CACS identified in non-gated MDCT is also associated with cardiovascular risk evaluated by FRS in a young population. Our findings suggest that young asymptomatic individuals with incidental CAC should be seriously evaluated for cardiovascular risk factors despite presumption of belonging to a low cardiovascular risk category.
先前的研究已经证实了心电图门控胸部计算机断层扫描（CT）测量的冠状动脉钙化（CAC）与心血管疾病之间存在相关性。最近的报告包括无症状患者，表明非心电图门控 CT 测量的 CAC 与心血管风险也有类似的相关性。本研究调查了 Framingham 风险评分（FRS）与在非心脏指征下进行的非门控胸部 CT 偶然发现 CAC 之间的相关性，该研究纳入了我院 18-50 岁的年轻且看似健康的患者。
对我院 162 例因非心脏指征行 CT 检查的年轻患者进行了一项横断面研究。采用 Agatston 法计算 CAC 评分（CACS）。计算 FRS 并使用三种不同方法与 CACS 进行比较。还评估了 CACS 与几个特定因素（即年龄、体重指数、吸烟、他汀类药物等）之间的相关性。
患者的平均年龄为 36.43 岁，105 例（64.8%）为男性。我们发现，在所有三种方法中，CACS 与 FRS 之间均存在显著的正相关（p<0.05）。年龄增长、吸烟和使用他汀类药物是唯一与 CACS 增加明显相关的个体因素（p=0.002、p=0.045 和 p=0.009）。
这是第一项表明在非门控 MDCT 中偶然发现的 CAC 也与年轻人群中用 FRS 评估的心血管风险相关的报告。我们的研究结果表明，尽管假定属于低心血管风险类别，对于偶然 CAC 的年轻无症状个体，应认真评估心血管危险因素。
